Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Premenstrual dysphoric disorder (PMDD) can be considered to be a severe form
of premenstrual syndrome (PMS). Both PMS and PMDD are characterized by
unpleasant physical and psychological symptoms that occur in the second half of
a woman's menstrual cycle,
most commonly in the days preceding the menstrual period. Fatigue, mood changes, irritability, and abdominal bloating are among the most common symptoms of PMS and PMDD, but numerous other symptoms have been reported. Whereas the symptoms of PMS may be troubling and unpleasant, PMDD may cause severe, debilitating symptoms that interfere with a woman's ability to function.
PMS is much more common than PMDD. PMS may affect to 30% of women with regular menstrual cycles, while only 3% to 8% of these women have true PMDD.
PMDD has been previously medically referred to as late luteal phase dysphoric disorder.
Although the precise cause of PMS and PMDD is unknown, it is believed that
these conditions result from the interaction of hormones produced by the ovaries
at different stages in the menstrual cycle (such as estrogen and progesterone)
with the neurotransmitters (chemicals that serve as messengers) in the brain.
While the ovarian hormone levels are normal in women with PMDD, it is likely
that the brain's response to these normally-fluctuating hormone levels is
Most evidence suggests that PMS and PMDD do not result from any specific
personality traits or personality types. While stress clearly is associated with
PMS and PMDD, it is not considered to be a cause of PMDD. Rather, the associated
stress is more likely to be a result of the symptoms of PMS or PMDD. Vitamin or
other nutritional deficiencies have not been shown to cause PMS or PMDD.
Medical Author: Carolyn Janet Crandall, M.D., FACP
Medical Editors: Melissa Conrad Stöppler, MD
Ms. B.T. is 38 years old. Her co-workers always
seem to know when she has her period. During this time, she becomes extremely
irritable. She feels guilty because she gets very angry at her children for no
logical reason or for apparently trivial reasons. In fact, one of her coworkers,
with whom she is quite friendly, suggested she come in before her supervisor
noticed problems on the job. She heard that there is a severe version of PMS
that requires special treatment. Ms. B.T. wants to know if this is her problem.
Premenstrual syndrome(PMS) has been the term
used for mood, and sometimes physical, symptoms that occur cyclically
(predictably in relation to menses) in the second half of the menstrual cycle and interfere with a woman's
quality of life. Some women experience even more severe symptoms. These women may have
a conditions known as premenstrual dysphoric disorder (PMDD).